2.0 DESCRIPTION
A deliberation with a specialist
physician, dentist, or qualified mental health provider requested
by the attending physician primarily responsible for the medical
care of the patient, with respect to the diagnosis or treatment
in any particular case.
3.0 POLICY
3.1 Consultations performed by
an individual professional provider at the request of the patient’s
attending provider are covered.
3.2 A consulting physician, dentist,
or qualified mental health provider may perform a limited examination
of a given system or one requiring a complete diagnostic history
and examination.
3.3 To qualify
as a consultation, a written report to the attending physician of
the consultant’s findings is required.
4.0 EXCLUSIONS
4.1 Telephone
consultations and telephone toll charges are not covered.
4.2 Staff consultations required
by the policies of a hospital or other institution.